Children wait to be vaccinated for measles at an MSF mobile vaccination site in Blantyre.

Since February 2010, Malawi has been facing its biggest measles epidemic in 13 years. Working with the local health authorities, Doctors Without Borders/Médecins Sans Frontières (MSF) has launched a vaccination campaign for more than 2.5 million children. While MSF medical teams continue to provide care to those infected with measles, more efforts will be needed at national and international levels in order to end this serious epidemic

According to Malawi’s official figures, in February more than 9,000 people fell ill and 44 people died. By now, the measles epidemic threshold has been surpassed in 23 of the country’s 28 districts, with measles cases continuing to affect new areas.

MSF teams have decided thus far to focus their efforts on the six districts with the highest attack rates—the numbers of new cases observed for a determined period and population. These districts are Blantyre, Chiradzulu, Lilongwe, Mangochi, Mzimba, and Thyolo.

In collaboration with Malawi’s Ministry of Health, MSF has provided medical care to 8,106 measles patients since April. MSF has been supporting 88 hospitals and health centers located in both rural and urban areas. MSF support includes reinforcing and training medical staff, and donating treatment and equipment. In Blantyre, after measles hit one of the main prisons, a 15-bed unit was set up inside the hospital for prisoners infected with the virus.

A baby is vaccinated against measles at an MSF mobile clinic in Blantyre.

Measles is a major cause of death for children and adolescents throughout the world. The disease may cause serious side-effects and increases the risk of malnutrition.

In an effort to fight and contain the epidemic, MSF, in collaboration with the Ministry of Health, launched several mass vaccination campaigns. Between May 3 and 18, MSF teams vaccinated 1.1 million children between six months and 15 years of age throughout Blantyre, Mzimba, and Chiradzulu districts. On the first day in Blantyre, more than 50,000 people were vaccinated, each vaccinator dealing with an average of 1,500 children per day. Since May 10, MSF is also intervening in the Thyolo district, where teams are expected to immunize around 285, 000 children.

Other mass vaccination campaigns are in preparation and should be starting soon in Lilongwe, targeting 900,000 children, and Mangochi, targeting 400,000 children. This should bring the total vaccinated to more than 2.5 million.

Other MSF teams are continuing to assess the situation in other districts, such as Machinga and Balaka in the southwest, where measles cases have also been reported. MSF teams will begin treating patients of all ages on June 12. Mass vaccination campaigns in these areas are expected to immunize around 400,000 children between six months and 15 years.

Additional international and national staff have arrived to reinforce teams already on the ground before the beginning of the epidemic. Some 1,300 MSF employees, most of them Malawian staff, are currently running MSF’s emergency activities.

But despite all these efforts, the current measles epidemic in Malawi has become very worrying. Therefore, more resources will need to be mobilized at national and international level to effectively tackle this epidemic and avoid the loss of many lives.

Measles—a regional emergency

Malawi is not the only southern African country to be hit by measles. Over the last few months, Mozambique, South Africa, Swaziland, Zambia, and Zimbabwe have recorded an increase in measles cases among their populations.

MSF logistics workers use a cold chain system to transport measles vaccines.

In Zimbabwe, the current measles outbreaks have affected 55 out of Zimbabwe’s 62 districts and killed 384 children. The Ministry of Health has launched a nationwide vaccination campaign targeting all children—approximately 5 million—between six months and 14 years of age. MSF is assisting the authorities in the provision of care and vaccinations in Buhera and Epworth.

In South Africa, the government has reported more than 14,000 measles patients in all nine provinces from the beginning of 2009 to May 2010. An increase in the number of new cases reported each week has been observed in some provinces, notably KwaZulu-Natal and Mpumalanga. MSF supported the vaccination in the township of Khayelitsha, targeting around 10,000 children between six months and 15 years of age.

In Mozambique, MSF provided support for a measles vaccination campaign taking place in the north on the border with Malawi.

MSF teams in Swaziland and Zambia are following up the measles situation closely in the country.